Jackie Spanjers spoke Wednesday about dangerous conditions that she and other nurses have to work under at the Anoka-Metro Regional Treatment Center. Behind her Gov. Mark Dayton. (The Minnesota Star Tribune)

Seeking to fill chronic gaps in Minnesota's mental health system, Gov. Mark Dayton is proposing $177.3 million to improve patient care and safety at state-run psychiatric facilities.

The proposal unveiled Wednesday would amount to the largest single-year appropriation for mental health in at least 20 years and is designed to correct years of underfunding. Inadequate staffing and a large influx of patients from county jails has led to a surge of violence and calls for reform at Minnesota's two largest state mental hospitals.

In a sharply worded report last month, the state legislative auditor concluded that Minnesota has yet to build a comprehensive system of mental health services, with many of the state's smaller psychiatric hospitals operating far below capacity.

"Decades of neglect have made these facilities more dangerous to both care providers and recipients," Dayton said. "It is imperative that the Legislature correct some of these deficiencies this year."

Dayton's plan is designed to ease bottlenecks that occur in the system by adding more beds, staffing and more active treatment in state-operated psychiatric facilities.

For the first time in years, the state's seven smaller psychiatric hospitals, which have 16 beds each, would be funded to operate at full capacity. And the state will develop a new program for psychiatric patients awaiting trial, freeing up another 30 beds.

In addition, about 335 full-time staff will be added over the next three years at the Minnesota Security Hospital in St. Peter and 33 new staff at Anoka-Metro Regional Treatment Center.

Though gaps in patient care have long been a problem, conditions reached a crisis point after the Legislature passed a law in 2013 designed to move people with mental illnesses more quickly out of county jails. The law, known as the "48-hour rule," required state psychiatric facilities to admit certain jail inmates deemed mentally ill ahead of hospital patients, creating backlogs throughout the system.

The bottlenecks are now so severe that nearly half the patients at Anoka Metro, the state's second-largest mental hospital, could be discharged but continue to occupy acute-care beds because they have nowhere else to go.

Dayton's package includes $30.3 million for Anoka Metro and the smaller community hospitals, plus $22 million for the Security Hospital for improved security systems, more staff and a special unit for patients with developmental disabilities. The Security Hospital would also get $70 million in physical renovations.

Dayton announced the package Wednesday morning flanked by three state hospital workers, who shared firsthand accounts of working with patients who are often unstable and sometimes violent. The number of injuries or illnesses reported by Security Hospital staff has increased from 83 to 142 since 2013.

"This [proposal] is long overdue," said Roberta Opheim, state ombudsman for mental health and developmental disabilities. "We absolutely have to invest in the system that we built and have neglected for much too long."

However, the governor may face resistance from legislators. The state's latest budget forecast showed a shrinking surplus, which majority House Republicans had hoped to use on tax cuts. Dayton has proposed $1.4 billion in overall borrowing for the traditional every-other-year bonding bill, including money for the hospital projects, but Republicans are pushing for far less.

And, in a year when all 201 legislative seats are up for election, lawmakers might rank mental health below fixing local roads and delivering new public projects. DFL Sen. Kathy Sheran, chair of the Health, Human Services and Housing Committee, said Dayton's plan may not be "the most glamorous way to spend money, but it is a moral imperative."

Some lawmakers and mental health advocates said they were withholding judgment until they see how Dayton's plan will reduce backlogs and improve care. "I am delighted by the attention that mental health is getting," said Rep. Diane Loeffler, DFL-Minneapolis. "But it's hard to change a system whose problems have been built over decades in one fell swoop."

Chris Serres • 612-673-4308

J. Patrick Coolican • 651-925-5042